question from a user

My SHBG is currently 12.0 nmol/L I am on 100mg/wk of test cyp - daily injections 1500iu hCG/wk Before TRT it was ~ 14 So bottom of the range. I reversed prediabetes last year. I wear a CGM. Track my food. Etc. For all intents and purposes I know I am insulin sensitive. My liver markers are great every time they are checked. Even whilst reversing prediabetes and while I had insulin problems. I’m currently 6’ / 203 lbs. Could def lose 20 and probably have more visceral fat than I need. My question is… other than dropping the 20 (and visceral fat)… does anything else stick out to you why my SHBG is chronically low. I also have RA (pretty much in remission)… my theory is that the associated inflammation could be impacting liver performance (lower Shbg) But it’s important for me to get this up, so that I can run higher TT & not be so sensitive / reactive to free hormones…. Also the benefit of SHBG to transport siad hormones to tissues that need it. My 8 week bloods were TT: 555 ng/dl (range: 300-1100) FT: 168 pg/ml (range: 70 - 155) E2: 36 pg/ml (range: <=29) SHBG 12 nmol/L (range: 10 - 50) I know everyone and their mother just cannot stop signing the praises of high e2… but for folks with low SHBG, this sucks. I feel good. CRUSHING the gym… but the libido stuff and mood stuff seem low… Getting that e2 to like 27 seems optimal in the short term, but getting SHBG up to like 25 seems optimal in the long term, such that I can run higher TT and then balance Ft and e2 with more precision. I saw you mention in my other comment about TT ~ 900 promotes anabolism whilst cutting.

AlphaMD's Answer

Your insights regarding why you have low SHBG seem accurate. First, being pre-diabetic, your body has been overproducing insulin for awhile. It often takes several years for you to return to normal insulin levels even if you are doing everything right regarding diet and exercise.

Also, the chronic inflammation from any rheumatic condition will negatively effect your SHBG levels.

It would be difficult to dial things in without medications, but it sounds like you are doing everything right otherwise as far as diet and exercise.

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